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Every year over 20,000 [3] people die as a result of being in a fire. Although flames have the biggest visual impact, it is usually the smoke produced by the combustion of natural and synthetic materials that causes more damage and claims more lives. The main constituents of smoke, both the particulate matter as well as the hot and toxic gasses, are devastating to the tracheal and lung tissues. The damage caused to the lung and trachea by inhaling this smoke can increase a fire victim's susceptibility to infectious disease significantly [1]. Between 20% and 50% of people who suffer inhalation injury contract pneumonia due to the weakened status of their body's defenses [2] and between 4,800 and 6,400 [1] people die from either pneumonia or other complications. Despite the importance of the inner-lining of the trachea to a burn victim's health and survival, current treatments consist of keeping the patient in a clean environment, supplying fresh oxygen, keeping the airways open, and letting the patient's body heal itself [1]. This treatment is not so much an active healing mechanism; rather it is a passive means of allowing the body to repair itself. The main goal of this work is to develop a minimally invasive technique that will replace lost cells on the inside surface of the trachea as efficiently as possible, actively healing the patient's injury. Ideally, the patient would receive a single treatment and then make a complete recovery on his or her own. The main challenge lies in delivering an even layer of intact cells to the inner-surface of the trachea in such a manner that they will stay in place and will replace the damaged or missing tissue. The overall approach is to spray a suspension, composed of epithelial cells in an aqueous solution of Pluronic F-127 polymer, onto the trachea using a jet atomizer. Because Pluronic F-127 solutions can be liquids at room temperature but gels at body temperature, the role of the polymer will be to immobilize the cells onto the tracheal surface long enough for them to attach and grow.

Thesis (M.Tech.: Emergency Medical Care)-Dept. of Emergency Medical Care and Rescue, Durban University of Technology, 2008. xii, 301 leaves, Annexures A-0 to A-7 / Paramedic clinical decision making (CDM) surrounding emergency airway management of the critically ill or injured patient in the pre-hospital environment is poorly understood. In order to deliver pre-hospital care effectively it is necessary to understand how paramedics make clinical decisions in this area and determine what influences clinical practice. This study primarily investigated the factors influencing paramedic CDM in the context of advanced emergency airway management with specific focus on the newly introduced skill of rapid sequence intubation (RSI). An evaluation of the correct application of RSI guidelines, the determination of the need for their review and the identification of measures to enhance CDM around RSI were secondary research questions.

A thesis submitted in fulflment of the requirements for the degree of Doctor of Philosophy in the School of Computer Science and Applied Mathematics. November 2015 / The understanding of uid ow at microscale geometrics is an increasingly important eld in applied science and mechanics, especially in bioinspiration and biomimetics. These elds seek to imitate processes and systems in biology to design improved e cient engineering devices. In this thesis, inspired by the e ciency of the insect tracheal system in transporting respiratory gases at microscale, mathematical models that both mimic and explain the gas exchange process are developed. Models for the simultaneous movement of respiratory gases across the insect spiracle, gas transfer from one respiratory chamber to the next, end di usion and tissue absorption at the tracheole tips, and tracheal uid transport are presented. Expressions for tracheal partial pressures of the respiratory gases, rate of change of gas concentrations, rate of tracheal volume change, spiracle behaviour on net gas ow, cellular respiration and tissue absorption, and global gas movement within the insect are presented as well. Two versions of bioinspired pumping mechanism that is neither peristaltic nor belongs to impedance mismatch class of pumping mechanism are then presented. A paradigm for se- lectively pumping and controlling gases at the microscale in a complex network of channels is presented. The study is inspired by the internal ow distributions of respiratory gases produced by rhythmic wall contractions in dung beetle tracheal networks. These networks have been shown to e ciently manage uid ow compared to current produced micro uidic devices. The insect-like pumping models presented are expected to function e ciently in the microscale ow regime in a simple or complex network of channels. Results show the ability to induce a unidi- rectional net ow by using an inelastic channel with at least two moving contractions. These results might help in explaining some of the physiological systems in insects and may help in fabricating novel e cient micro uidic devices. In this study, both theoretical and the Di erential Transform Method are used to solve the exible trachea with gas exchange problem as well as the 2D viscous ow transport with or without prescribed moving wall contractions problem. Both Lubrication theory and quasi- steady approximations at low Reynolds number are used in the derivation of theoretical analysis. ii Moreover, an analytical investigation into the compressible gas ow with slight rarefactions through the insect trachea and tracheoles is undertaken, and a complete set of asymptotic analytical solutions is presented. Then, estimation of the Reynolds and Mach numbers at the channel terminal ends where the tracheoles directly deliver the respiratory gases to the cells is obtained by comparing the magnitude of the di erent forces in the compressible gas ow. The 2D Navier-Stokes equations with a slip boundary condition are used to investigate the compressibility and rare ed e ects in the respiratory channels.

Orientador: Norma Sueli Pinheiro Módolo / Banca: Lais Helena Navarro e Lima / Banca: Eliana Marisa Ganem / Banca: Leopoldo Muniz da Silva / Banca: Angélica de Fátima de Assunção Baga / Resumo: A intubação traqueal de pacientes pediátricos, especialmente de crianças com idade inferior a oito anos, foi por muito tempo realizada exclusivamente com uso de tubos traqueais sem balonete devido ao risco do mesmo causar lesão na mucosa traqueal. Diversos estudos demonstraram a possibilidade do uso de cânulas traqueais com balonete de alta complacência e baixa pressão em crianças sem ter ocorrido aumento do risco de lesões de via aérea. O emprego da lidocaína alcalinizada no preenchimento do balonete apresentou diminuição na incidência de morbidade laringotraqueal no pós-operatório em adultos. Contudo, não há estudos comparando o uso de balonete preenchido com lidocaína alcalinizada e seus benefícios na população pediátrica. Comparar a utilização de cânulas traqueais com balonetes preenchidos com solução fisiológica, ar ou lidocaína alcalinizada a 1% e a 0,5% na prevenção de morbidades laringotraqueais, da agitação e da alteração hemodinâmica, no período pós-operatório, em pacientes com idade de três a 13 anos submetidos à anestesia geral. Cento e sessenta e quatro pacientes pediátricos submetidos à anestesia geral balanceada foram distribuídos em quatro grupos, de acordo com o preenchimento do balonete do tubo traqueal: grupo SF (n 41) preenchido com solução fisiológica 0,9%; grupo AR (n= 41) preenchido com ar ambiente; grupo L1% (n=41) preenchido com lidocaína alcalinizada a 1%; grupo L 0,5% (n=41) preenchido com lidocaína alcalinizada a 0,5%. Os balonetes foram lubrificados com gel hidrossolúvel antes da intubação traqueal e, após a intubação traqueal, preenchidos com ar ou a solução de acordo com o grupo até ser obtida a pressão de selo. A pressão do balonete foi mantida abaixo ou igual a 20 cm H2O. Os dados relativos aos atributos hemodinâmicos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Tracheal intubation in pediatric patients, especially children under 8 years old, was for long performed exclusively with uncuffed tracheal tubes due to the risk of tracheal mucosal damage. Several studies have demonstrated the possibility of the use of cuffed tracheal tube with high compliance and low pressure in children. Its use has occurred without increasing risk of airway injury. The use of alkalized lidocaine filling the cuff showed a decrease in the incidence of laryngotracheal morbidity in adults postoperatively. However, there are no studies comparing the use of cuff filled with alkalinized lidocaine and its benefits in the pediatric population. compare the use of cuffed tracheal tubes filled with saline, air or alkalized 1% and 0.5% lidocaine in preventing laryngotracheal morbidity, and hemodynamic changes in the postoperative period in patients aged between 3 and 13 years undergoing general anesthesia. one hundred sixty four pediatric patients undergoing balanced general anesthesia were divided into four groups, according to the filling of the tracheal tube cuff: saline group (n=41) filled with 0.9% saline; AR group (n=41) filled with ambient air; L1% group (n=14) filled with alkalinized 1% lidocaine; group L 0.5% (n=41) filled with alkalinized 0.5% lidocaine. All cuffs were lubricated with water-soluble gel before tracheal intubation. After tracheal intubation, they were filled until reaching sealing pressure. The cuff pressure was kept below or equal to 20 cm H2O. Data on respiratory and hemodynamic parameters were obtained before intubation and after 30, 60, 90 and 120 minutes of anesthesia and at the end of surgery, immediately before and after extubation. After 30 minutes of intubation, a sample of peripheral venous blood was collected from patients who had the cuffs filled with lidocaine for determination of its plasma concentration... (Complete abstract click electronic access below) / Doutor

Foram estudados os efeitos da metilprednisolona na traquéia de coelhas albinas adultas da raça Nova Zelândia. O objetivo deste estudo foi investigar os efeitos potenciais desta substância nas propriedades biomecânicas da traquéia de coelhas por meio de ensaio de tração axial. Os animais foram divididos em dois grupos. Dez coelhas do grupo controle receberam por via subcutânea 2 mg/Kg/dia de metilprednisolona diluída em solução salina. As dez coelhas do grupo controle receberam também de modo subcutâneo volumes proporcionais de solução salina. Após 21 dias, os animais foram sacrificados e suas traquéias submetidas a ensaio de tração e estudo histopatológico. Os animais do grupo experimental apresentaram peso significantemente inferior ao do grupo controle no final do tratamento (C = 3996 ± 314 g x E = 3555 ± 373 g). Os grupos não diferiram do ponto de vista estatístico quanto as seguintes variáveis: carga no limite de proporcionalidade (C = 8,94 ± 1,68 N x E = 8,93 ± 1,52 N); carga máxima (C = 9,12 ± 2,2 N x E = 9,57 ± 1,90 N); alongamento no limite de proporcionalidade (C = (683 ± 2,08) x '10 POT.-3' m x E = (6,05 ± 1,50) x '10 POT.-3' m); alongamento máximo (C = (7,44 ± 2,60) x '10 POT.-3' m x E = (6,85 ± 1,55) x '10 POT.-3' m); energia absorvida na fase elástica (C = (28,70 ± 14,43) x '10 POT.-3' J x E = (27,75 ± 11,06) x '10 POT.-3' J); rigidez (C = (1,08 ± 0,41) x '10 POT.-3' N/m x E = (1,2 ± 0,37) x '10 POT.-3' N/m). Concluiu-se ao término deste estudo que não houve alterações morfológicas e biomecânicas das traquéias estudadas, no entanto, os animais do grupo experimental sofreram significante emagrecimento ao final do tratamento, quando comparado ao grupo experimental / The effects of methilprednisolona in the adult’s trachea albinos female rabbits were studied. The goal of this study was examine the potential effects of this armorial traction. The animals were divided in two groups. Ten female rabbits of control group received by way of subcutaneous 2mg/kg/day of salt bed diluted solution. These ten female rabbits of the control group also received by way of subcutaneous proportional volumes of salt bed solution. After 21 days, the animals were sacrificed and their trachea were subjected to traction tests and anatomical pathological studies. Animals of the experimental group presented inferior weight significant from the control group in the end of the treatment (C = 8,94 ± 314g X E = 3555 ± 373g). The groups didn’t differ from the statistic point of view as regards of the following variables: limit load of proportionality (C = 8,94 ± 1,68 N X E = 8,93 ± 1,52 N); maxim load (C = 9,12 ± 2,2 N X E = 9,57 ± 1,90 N); stretch out on the limit of proportionality (C = (683 ± 2,08) x '10 POT.-3' m X E = (6,05 ± 1,50) x '10 POT.-3' m); maxim stretch out (C = (7,44 ± 2,60) x '10 POT.-3' J X E = (6,85 ± 1,55) x '10 POT.-3' J); absorbed energy in the elastic phase (C = 28,70 ± 14,43) x '10 POT.-3' m J X E = (27,75 ± 11,06) x '10 POT.-3' J); rigidity (C = 1,08 ± 0,41) x '10 POT.-3' N/m X E = (1,2 + 0,37) x '10 POT.-3' N/m). It was concluded in the end of the treatment that there weren’t any morphological and biomechanical alterations of the trachea studied, although, the animals of the experimental group suffered a significant slimming in the end of the treatment when compared with the experimental group

No description available.

Thesis (M.Tech.: Emergency Medical Care)-Dept. of Emergency Medical Care and Rescue, Durban University of Technology, 2008. xii, 301 leaves, Annexures A-0 to A-7 / Paramedic clinical decision making (CDM) surrounding emergency airway management of the critically ill or injured patient in the pre-hospital environment is poorly understood. In order to deliver pre-hospital care effectively it is necessary to understand how paramedics make clinical decisions in this area and determine what influences clinical practice. This study primarily investigated the factors influencing paramedic CDM in the context of advanced emergency airway management with specific focus on the newly introduced skill of rapid sequence intubation (RSI). An evaluation of the correct application of RSI guidelines, the determination of the need for their review and the identification of measures to enhance CDM around RSI were secondary research questions.

En esta tesis se aborda el tema de la intubación traqueal. Primero se realiza una introducción histórica y a continuación se analizan los problemas derivados de la aplicación de la intubación. Seguidamente se realiza un estudio compartido entre tres modelos de tubos, dotados de manguitos diferentes, durante períodos de intubación variables (6, 24 y 48 horas), aplicados a perros anestesiados. Las muestras traqueales extraídas fueron estudiadas mediante microscopia óptica y electrónica, concluyendo que el factor tiempo de intubación y el valor de las presiones alcanzadas por los manguitos son los determinantes de la patología observada (exocitosis, infiltración leucocitaria, atrofia del epitelio, erosión, hiperplasia y metaplasia escamosa), siendo los menos lesivos los tubos con manguito de baja presión.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv. / Härtill 5 uppsatser.